MS and the COVID-19 vaccine

Source: MS Society UK 

Can I get a COVID-19 vaccine? Are the coronavirus vaccines made by Pfizer-BioNTech, Oxford-AstraZeneca or Moderna ‘live’ vaccines?  

We’ve spoken to leading healthcare professionals to help answer these and other questions you might have about COVID-19 vaccines and MS.

Your own MS team can give you more advice about getting the vaccine. They can give you advice based on your circumstances, any treatments you take, and whether getting a COVID-19 vaccine is right for you.

Our medical advisers have published a consensus statement about COVID-19 vaccines and disease modifying therapies (DMTs).

We updated this page on Tuesday 12 January to reflect the news that a third vaccine has been approved, made by Moderna.

On Monday 4 January we updated with the news that unpaid carers (friends or family who help care for someone) are now included in the UK priority list to get the coronavirus vaccine

  1. Can I get a COVID-19 vaccine now?
  2. When can I have a COVID-19 vaccine?
  3. Why are there different COVID-19 vaccines being developed?
  4. Are the Pfizer-BioNTech and Oxford-AstraZeneca coronavirus vaccines ‘live’ vaccines?
  5. How do the COVID-19 vaccines work?
  6. Have the COVID-19 vaccines been tested in people with MS?
  7. How do we know that the COVID-19 vaccine will be safe and effective for people with MS?
  8. Will a COVID-19 vaccine interfere with my other medications?
  9. Will the vaccine be available on the NHS?
  10. Will health and social care professionals be given the COVID-19 vaccine?
  11. Will my partner or carer be eligible for a COVID-19 vaccine?

1. Can I get a COVID-19 vaccine now?

People started receiving a COVID-19 vaccine in December 2020. At first, it’s available to groups of people on the UK government’s priority list – starting at the top of the list, which we set out below.

There’s no need to apply for the vaccine or ask your GP or pharmacist for an appointment. People will be invited automatically.

On 2 December a coronavirus vaccine made by Pfizer-BioNTech was approved in the UK. This approval was given by the UK government and the Medicines and Healthcare products Regulatory Agency (MHRA) – a government body which makes sure medicines and devices work safely.

On 30 December they approved a second vaccine for COVID-19, developed by Oxford University and AstraZeneca. 

A third vaccine, made by Moderna, has also been licensed. Supplies of this are not expected in the UK until spring 2021 at the earliest. 

Even though vaccines have been approved, it will take many months for everyone to be vaccinated. In preparation, the UK government pre-ordered millions of COVID-19 vaccines so they’re ready as soon as possible.

There’s a UK-wide plan to prioritise certain groups to be vaccinated first. The priority groups are:

  • residents in a care home for older adults and their carers
  • people 80 years of age and over and frontline health and social care workers
  • people 75 years of age and over
  • people 70 years of age and over and clinically extremely vulnerable individuals
  • people 65 years of age and over
  • everyone aged 16 to 64 with underlying health conditions which put them at higher risk of serious disease and mortality and unpaid carers (friends or family) 
  • people 60 years of age and over
  • people 55 years of age and over
  • people 50 years of age and over

People considered ‘clinically extremely vulnerable’ have the same priority as people aged 70 and over.

Adults aged 16-64 who are in a ‘higher risk’ group includes people living with MS.

But there might be exceptions to this, based on advice from your MS team. They could say a vaccine isn’t right for you at this time.

2. When can I have a COVID-19 vaccine?

A COVID-19 vaccine could be available for some people with MS as early as December 2020. But this depends where people are on the priority list and it will take time to vaccinate all the priority groups.

At the moment we don’t know how soon someone will get a vaccine, and plans might change – especially if we learn more about how effective the vaccines are for different people.

Getting the vaccine to people around the UK is a complicated process. In particular, the Pfizer-BioNTech vaccine is difficult to distribute because it needs to be kept very cold. And the regulators still have to split the vaccine into individual doses – which is needed for vaccinations outside of hospitals and special GP centres. But with all COVID-19 vaccines, there have to be local and national plans to make them available.

In England, this involves hospital ‘hubs’ and special GP vaccination centres. The hospital will get in touch with you by letter or phone if you have been identified as priority for the vaccine (by using your medical records). 

In the coming weeks, the vaccines will also be rolled out to care homes and to bigger vaccination centres across the country. The government are hoping to vaccinate the most vulnerable groups by spring 2021.

In Wales, the government plan to deploy the vaccine in phases – starting with hospitals and then in community settings, which will include mobile vaccination centres. People will be sent appointments depending on where they are on the schedule and their risks.

There’s no need to apply for the vaccine or ask your GP or pharmacist for an appointment. People will be invited automatically. And local councils and the NHS will write to everyone in Wales in early January with more information about coronavirus vaccination.

In Northern Ireland, the first phase of vaccination roll-out started with care home residents and staff, as well as front-line healthcare workers. The plan is now for everyone over 80 to get their first dose of the vaccine by the end of January and other priority groups after that.  

In Scotland the first doses of the vaccine will go to 23 hospitals who can store them. By January, the government is planning to train over 2,000 ‘vaccinators’ to administer the vaccine. The first people to receive the vaccine will be these ‘vaccinators’ themselves. The government will then roll it out to people on the priority list, starting with older residents in care homes, health and social care workers, and those aged over 80. They hope to complete the first phase of the vaccination programme by spring 2021.

These plans are being reviewed regularly and they could change if new vaccines are approved and as more information is collected.

Read the UK government Q&A about why you might have to wait for the vaccine

Read the UK government information for healthcare professionals and the public about the Pfizer-BioNTech vaccine

Read the UK government information for healthcare professionals and the public about the Oxford-AstraZeneca vaccine

3. Why are different COVID-19 vaccines being developed?

Different COVID-19 vaccines are being developed to give us the best chance of finding effective ones. There are lots of ways to make a vaccine for a virus. What they all have in common is getting our immune system ready to fight off the virus. They make sure our system recognises the virus if it gets in.

Researchers from around the world are all working to develop vaccines for COVID-19. And at the start of the race to find it, no-one knew for sure what approach would work best.

There seem to be several different types that work well, and it could mean we have different vaccines for different groups of people. For example, older people’s immune systems might respond best to one, while teenagers find another more effective.

Having lots of different approaches also makes it more likely we’ll find better ways to store and deliver the vaccine. Some need super-cold storage, others can be kept in a household fridge for months on end. The first vaccines to report results – including the approved vaccines – need 2 jabs. It’s possible that others might need only one, or be given as a nasal spray.

4. Are the Pfizer-BioNTech and Oxford-AstraZeneca coronavirus vaccines ‘live’ vaccines?

The approved Pfizer-BioNTech and Oxford-AstraZeneca coronavirus vaccines are not ‘live’ vaccines. Neither is the third vaccine that’s approved, made by Moderna. 

A ‘live’ vaccine contains a weak version of the virus or bacteria they prevent. Many neurologists would suggest you avoid ‘live’ vaccines if you’ve recently taken certain DMTs or high-dose steroids. This is because although the virus or bacteria that the vaccine contains is weakened, there is still a small chance that it can cause disease in people with immune systems that have been weakened by DMTs.

The approved vaccines for COVID-19 work in a different way.

5. How do the COVID-19 vaccines work?

The Pfizer-BioNTech vaccine is what’s known as a ‘messenger RNA (mRNA) vaccine’. The Moderna vaccine also works in this way. The Oxford-AstraZeneca vaccine has a different way of working – it’s known as a ‘viral vector vaccine’.   

Messenger RNA – using the genetic code

The messenger RNA (mRNA) vaccines don’t contain any pieces of the actual coronavirus. Instead, they contain part of the genetic code of the virus, carried by the mRNA. These vaccines work by injecting this part of the coronavirus’s genetic code, which trains the body’s immune system to attack coronavirus if it’s exposed to it.

You can read more about the way these 2 vaccines work on the Pfizer and Moderna websites – the drug companies which have developed them.

The Oxford vaccine – a ‘viral vector vaccine’

The other vaccine has been developed by the University of Oxford and drug company AstraZeneca. It’s known as a ‘viral vector vaccine’. It uses a weak version of the virus that causes the common cold in chimpanzees. This helps it get into the body like an actual virus would. But in the vaccine, this virus has had its genetic code changed so that it can’t actually cause disease in humans.

The change also means it’s got the genetic code for one particular part of the coronavirus – the ‘spike protein’. It’s just that, a spike on the outside of the virus that it uses to get inside our cells.

The vaccine makes the same spike so our immune system can recognise it if the actual coronavirus gets in – and then fight it off.

6. Have the COVID-19 vaccines been tested on people with MS?

We don’t know yet how many people with MS might have taken the COVID-19 vaccines during the clinical trials. That detail about who was on the trials hasn’t been published yet.

But we do know they looked at whether the vaccines worked on people with certain medical conditions and in older people. They did this because the immune responses for these people can work less effectively and therefore give them less protection through vaccines.

The 3 vaccines which have shared their initial results show the vaccine is between 70-95% effective in people involved in the trial as a whole.

Pfizer-BioNTech plan to check how effective the vaccine is for people with weakened (‘compromised’) immune systems – for example if you use certain DMTs. They’ll do this through a clinical trial and through their ongoing monitoring of people in the months and years after taking the vaccine.

7. How do we know the COVID-19 vaccine will be safe and effective for people with MS?

All new medicines have to go through rigorous safety tests in clinical trials – including vaccines. This includes 3 stages of clinical trials where people who take the vaccine are very closely monitored. Researchers constantly check the safety and side effects through these trials.

Although the trials for the coronavirus vaccines have been accelerated, safety processes have still been carried out as normal.

The process can take up to a few months, but the process has so far been quicker for COVID-19 because the experts are prioritising and checking data as it’s produced – rather than waiting until after everything is completed as they usually would. So they can speed up the process while keeping it thorough.

Any COVID-19 vaccine is only approved once it meets these robust standards of effectiveness, safety and quality.

Association of British Neurologists

The Association of British Neurologists (ABN) say they don’t expect that COVID-19 vaccines will worsen someone’s MS – for example, by causing a relapse. And they have no reason to believe these will be dangerous in people with MS, including people taking immunosuppressive drugs.

We don’t know for sure that the vaccines will work for everyone with MS. It’s possible that people on some MS treatments might have a reduced response to the vaccines.

This could happen because vaccines work by triggering an immune response and DMTs work by dampening down the immune system. This effect from the DMT might change over time. So you may have a reduced response for some time after an infusion, for example, but this might not be permanent.

Our medical advisers say that even a reduced response is likely to be better than none, so you should still get vaccinated if you’re on a DMT that might affect the vaccine like this.

Your own MS team can give you more advice, based on your circumstances, any treatments you take, and on whether getting a COVID-19 vaccine is right for you.

The UK government has said that adults who have a weakened immune system (‘immunocompromised’) should get a COVID-19 vaccine as a matter of priority. They say this includes people having stem cell transplants, and adults receiving alemtuzumab, ofatumumab or rituximab. This doesn’t guarantee the vaccine will be completely effective if you take these treatments, but you will get priority if you and your MS team agree it’s right for you.

Now a vaccine has been approved, there will be lots more information coming out about possible side effects and anyone who should avoid or delay taking that particular vaccine. We’ll keep up to date with any changes.

Read our medical advisers’ statement on treatments and COVID-19 vaccines

8. Will a COVID-19 vaccine interfere with my other medications?

At the moment, we’re not sure if a COVID-19 vaccine will interfere with other medications you might be taking. But our medical advisers don’t think the COVID-19 vaccine will stop DMTs from working. They say this because of what we know about the way these vaccines work, and evidence from studies of other vaccines and MS.

Read our medical advisers’ consensus statement

Before getting the vaccine, speak with your MS team about your circumstances, including any treatments you take.

9. Will the vaccine be available on the NHS, or can I pay for a COVID-19 vaccine?

The vaccines developed by Pfizer-BioNTech, Oxford-AstraZeneca and Moderna will be available on the NHS and free of charge to those who are eligible. At first, this will be for people on the priority list. So a vaccine might not be available to you on the NHS straight away.

We don’t know yet if other vaccines being developed will also be available on the NHS.

At some point, people might be able to buy the vaccine, but this isn’t certain to happen and you can’t at the moment.

10. Will health and social care professionals be given the COVID-19 vaccine?

Many health and social care professionals will be given the COVID-19 vaccine.

Health and social care staff are at risk of contracting COVID-19, but also of passing it on to the people they care for. The UK government have made it clear that the NHS and social care system needs to be protected so services can continue as normal.

Care home staff and their residents are considered highest priority for vaccination, with health and social care workers following them.

11. Will my partner or carer be eligible for a COVID-19 vaccine?

Partners and unpaid carers who provide care and support to someone living with MS are now on the priority list for the COVID-19 vaccine.

If you’re the main carer for someone, you’re now on the list alongside people aged 16 to 64 who have underlying health conditions. The UK government says this applies if you’re ‘in receipt of a carer’s allowance’, or you’re ‘the main carer of an elderly or disabled person whose welfare may be at risk if the carer falls ill’.

Of course, family members and unpaid carers might also be in the priority list for other reasons, like their age or a health condition.

This page was last updated Tuesday 12 January 2021

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